Laser Cataract Surgery

Since the early 1970’s cataract surgeons have pursued better cataract outcomes by incorporating ultrasonic technology (phacoemulsification) to break up and remove cataracts. Although cataract surgery is considered to be one of the safest and most successful procedures performed in medicine today, laser cataract surgery improves the precision of many key surgical steps to provide even better outcomes and potentially make cataract surgery even safer.

Why Laser Cataract Surgery?

Invented by Charles Kelman, MD, Phacoemulsification cataract surgery has been around 1967. This technology pioneered the way to small incision surgery that has made cataract surgery one of the safest and most successful procedures in medicine today. Phacoemulsification is still considered the state of the art cataract removal technique, however there are many steps in the cataract procedure that are still performed manually with either a surgical blade, a bent needle or forceps. Surgeons using the femtosecond laser, now perform these steps adding a greater amount of precision and improved visual outcome to the entire cataract procedure.

The Procedure:

Primary Stair Stel Self Sealing Incision

Bladeless Cataract Surgery only takes 15 or 20 minutes. In addition to using the femtosecond laser to do many of the surgical steps traditionally performed by hand, we use many of the best innovations in cataract surgery, such as drops only anesthesia (no shots), sutureless incisions through the clear cornea and foldable intraocular lenses. These advances allow us to use the smallest possible incision, approximately 1/18th of an inch.

In addition to using the laser to create a stair-stepped, self sealing incision to begin the procedure, an opening in the thin membrane that surrounds the natural lens can now be made with the laser. This step, the capsulorhexis, is one of the most delicate steps in cataract surgery and is critical to the efficacy of the procedure. In fact, your replacement Intra-Ocular Lens (IOL) is placed through the capsulorhexis into the membrane and it is critical to a good refractive outcome.The capsulorhexis also provides your surgeon with an opening to begin the removal of the cataract. Once the cataract is removed, the remaining capsular bag serves as a platform to hold the IOL. The round capsulorhexis is usually about 5 millimeters in diameter and will hold a 6 millimeter or larger IOL. If the capsulorhexis not made uniformly it may cause the IOL to tilt or move as the capsular bag contracts around the IOL during the healing process. If the capsulorhexis torn during the manual process, it could prevent the insertion of certain types of IOLs, thus compromising the desired outcome.

Capsulotomy

In traditional cataract surgery, once the capsulorhexis is made manually, the lens has to be chopped into manageable pieces with the ultrasonic power of the phacoemulsification instrument. Certain complications could be induced during this step such as rupturing the posterior of the capsular bag and causing injury to the delicate zonular fibers that hold the capsular bag in place and help the natural lens change its shape. In order for the new technology multifocal and accommodating IOLs to function at peak performance, the integrity of the zonular fibers must not be compromised. In order to prevent injury to the zonular fibers, the femtosecond laser is used to gently break apart and soften the cataractous lens.